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Definition

Adrenocortical carcinoma is cancer of the adrenal cortex. The adrenal glands are 2 glands located above each kidney. The glands produce important hormones. These hormones regulate heart rate, blood pressure, and many other vital functions, including response to stress and infection. The adrenal cortex is the outside layer of the 2 adrenal glands.

Cancers of the adrenal cortex are rare. The majority of these tumors produce excess hormones. The excess hormones can change hormonal balance.

Causes

Risk Factors

There are few known risk factors for cancers of the adrenal cortex. A genetic defect may cause adrenocortical cancer in some children, but the majority of cases are nonhereditary.

Symptoms

Approximately 40% of people with adrenocortical carcinoma do not secrete any hormone. These people do not have any specific symptoms. Adrenocortical carcinoma is discovered as part of a physical examination for abdominal pain.

Other tumors are hormonally active. Excess hormones may produce symptoms such as:

Pain in the abdomen, side, and/or back

Nausea and vomiting

Unintended weight loss

Diagnosis

You will be asked about your symptoms. A medical and family history will be collected. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

Blood tests

Urine tests

Images may be needed of your bodily structures. These can be made with:

After cancer of the adrenal cortex is confirmed, you will be referred to a cancer specialist.

Additional testing will be done to determine what stage the cancer has reached. The stage of a tumor is determined by its size and how far it has spread from its point of origin.

Treatment

Treatment depends on the stage of the tumor and your overall health. Talk with your doctor about the best plan for you.

The following methods are used to treat cancer of the adrenal cortex:

Adrenalectomy

Adrenalectomy is a surgical procedure to remove the adrenal tumor is the first treatment approach for most cases. Surrounding tissues or lymph nodes that contain cancer cells may also need to be removed.

Chemotherapy
and
Radiation Therapy

Chemo- or radiation therapy tend to be less effective in treating this type of cancer. They are most often used if the cancer has spread. Chemotherapy may also be used if there is a high chance the cancer will come back.

Other Therapies

Mitotane is the drug most often used for this type of cancer, especially for hormonally active tumors. It blocks hormone production by the adrenal gland. It also destroys adrenal cancer cells. This drug does have serious side effects.
It is sometimes given in combination with other drugs.

Other hormone-blocking drugs may be given to control the symptoms of excess hormones.

Research of new drug and radiation therapies are under way. This includes gene and immunotherapy.

If treatment is successful, you will still need to be screened for reoccurrence of the cancer on a periodic basis.

Prevention

There are no current guidelines to prevent adrenocortical carcinoma.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.